Dilation and Curettage

Curettage belongs to relatively small gynecological surgical procedures involving a tool called the curette which is used to remove parts of the mucosa of the uterine cavity or from the cervix. To be able to insert the curette into the uterine cavity at all, the cervix must first be widened (dilated).

The reasons for this procedure being carried out can be diagnostic in nature whereby its purpose is to identify the cause of gynecological complications (for example to see why a women bleeds irregularly, strongly, for too long or why bleeding occurs when it should not - after menopause). It can also be part of the treatment where the procedure is used to stop uterine bleeding or to remove polyps found in the uterus.

Prior to the procedure

You should receive all important information concerning the planned procedure from your doctor.

You should however inform your doctor with the following information:

You suffer from allergies

Any long-term medication you are using

Any coagulation disorders you may have (bleeding disorders)

Any surgeries you have undergone

Any other disease that you are suffering from

Prior to the procedure itself, you can eat dinner. However, from midnight onwards, you should not drink or eat anymore. If you are using long-term medication, ask your doctor if you should take them on the day of the procedure.

During the procedure

The surgical procedure is most commonly carried out under short general anesthesia. During the anesthesia, your veins will be supplied with medication to ensure that you are asleep and relaxed throughout it being carried out. Less frequently, especially with women suffering from chronic disease where general anesthesia is risky, the procedure is carried out using local anesthesia where the anesthetic is applied directly to the cervix.

The procedure is carried out in the so-called gynecology position where you lay down your back with your feet angled and supported.

After the insertion of the speculum into the vagina, the cervix is widened (dilated) using metal dilating rods. Once the cervix is dilated enough, the curette is introduced which will be used to remove the mucosa. All the tissue extracted during this surgery will be sent for a further histological examination. The entire procedure lasts between 15 and 30 minutes.

After the procedure

After you wake up from the procure, you will find yourself in the resting room where you will remain for 4 more hours. Only once you are fully conscious and stable, you will be released from the clinic. For the journey home, please make sure you have someone to take you. You should most definitely not drive yourself. Overnight hospitalization, considering all went smoothly is unlikely. In the first hours following surgery, you can feel nauseous or like vomiting. In such cases, you will be given medication to make you feel better. In case you were intubated during the procedure (you had a flexible plastic tube applied to allow you to breathe), you can experience pain and scratching in your throat. This uncomfortable feeling can be alleviated with any menthol lozenges. Following the surgery, you can also experience lower abdominal pain and bleeding. Generally, this only lasts for a couple days and should disappear entirely within 2 weeks.

What to ensure following the procedure

You should not drive a car for 24 hours after the procedure.

For the first 4 days following the procedure, measure your body temperature 2x per day and note down the measurements in case you would need to urgently visit a doctor.

Avoid any heavy physical strain for a period of 1 week following the procedure. For the same amount of time, avoid lifting heavy objects (5 Kg and more).

For a period of 2 weeks, only use the shower instead of baths, or accordingly based on the recommendation by the doctor responsible for treating you. For the same time (at minimum), do not swim, use tampons or flush the vagina.

You can have sexual intercourse 14 days after the procure (at minimum)

Complications

Complications following this procedure are quite rare. They can be split into early and latent in nature. During the procure, the wall of the uterus can be damaged including a perforation or tearing of the cervix. Latent complications can include adhesions around the cervix, namely in the cervical canal or the uterine cavity (so-called Asherman's Syndrome).

When should you call an emergency?

When you suffer from pain that is not getting better even after using painkillers or you experience sudden and escalating pains.

When you identify a smelly discharge from the wound or the vagina.

When you experience a rash.

When you start bleeding more than you do during menstruation or you are bleeding with blood clots.